FACTORS ASSOCIATED WITH THE USE OF INTRAPARTUM EPIDURAL ANALGESIA

Objective: To evaluate the influence of socioeconomic factors and prov ider characteristics on the use of intrapartum epidural anesthesia. Me thods: A total of 8229 deliveries at five hospitals were reviewed retr ospectively. Bivariate analysis was performed to identify potential bi ases in epidural use. Logistic regression was performed to control for confounding variables. Results: Epidural use was predominantly relate d to parity, with nulliparous women more likely to use an epidural dur ing labor. In hospitals where epidurals were used in a higher percenta ge of women, we found an association between the woman's insurance sta tus and the specialty of the physician managing labor. Race also appea red to be associated with epidural use in the participating hospital t hat had a large non-white population. Conclusion: Use of intrapartum e pidural analgesia varies considerably among sites and is associated wi th nulliparity, higher maternal age, and several nonclinical factors.